Objective:In order to improve medical undergraduates' ability to interpret medical images and clinical application competencies, this study aimed to explore the effects of case-based learning (CBL) combined with seminars for integrated medical imaging teaching as well as its application value.Methods:We assigned 40 medical undergraduates of grade 2016 of Chongqing Medical University to learn imaging of liver diseases using either a traditional teaching model (control group, n=20) or the combined teaching model (experimental group, n=20), in the form of classroom teaching in our hospital. The teaching effects were evaluated through a theoretical assessment, image reading assessment, and questionnaire survey. SPSS 23.0 software was used for statistical analysis. Continuous data were compared using the t test, and categorical data were compared using the chi-square test. Results:The total theoretical score and total image reading score of the experimental group were (76.35±8.63) and (79.80±10.60), respectively, which were significantly higher than those of the control group ( P<0.05). Specifically, for the experimental group, the scores of theoretical analysis and comprehensive application were (22.85±3.63) and (22.15±2.92), respectively; the scores of image interpretation and report writing were (48.55±6.81) and (31.25±4.15), respectively; the scores for medium questions and hard questions in the image reading test were (24.85±3.12) and (22.50±2.91), respectively; and the pass rate and excellence rate for image reading were 100.00% and 50.00%, respectively, all significantly higher than those of the control group ( P<0.05). The degree of satisfaction with teaching in the experimental group was significantly higher than that of the control group ( P<0.05). In terms of improving learning desire, independent learning ability, innovation and expansion ability, literature search ability, communication and collaboration ability, and image interpretation ability, the experimental group showed significantly higher self-evaluated scores than the control group ( P<0.05). Conclusions:The CBL+seminar model can effectively improve students' academic performance in theoretical and image reading assessments, strengthen their ability to analyze and solve difficult problems, increase their enthusiasm and initiative in learning, and improve their comprehensive quality and image interpretation competency, which is worth promotion and application.

Objective:By observing the effects of Calycosin on the proliferation and migration of human renal cancer 769-P cell, to explore the possible molecular mechanism of Calycosin against renal cancer.Methods:769-P cell were cultured with different concentrations of Calycosin [0, 12.5, 25, 50, 100, 200 μmol/L, dissolved in Dimethyl sulfoxide (DMSO)], and the effects of different concentrations of Calycosin on the viability of 769-P cell was detected by CCK8 method. The 769-P cell treated with 200 μmol/L Calycosin were used as the Calycosin group, and the 769-P cell treated with DMSO were used as the control group. The cell colony formation assay and cell scratch assay were used to detect the effects of Calycosin on the proliferation and migration of 769-P cell, respectively. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was used to detect the effect of Calycosin on the expression of miRNA-1246 and chemokine receptor-4 (CXCR4) in 769-P cell. Western blotting method was used to detect the effects of Calycosin on the expression of CXCR4 and extracellular signal-regulated kinase (ERK) pathway proteins in 769-P cell. Measurement data were expressed as mean ± standard deviation ( ± s), and one-way ANOVA was used for comparison between multiple groups, while t-test was used for comparison between two groups. Results:After cultured with 0, 12.5, 25, 50, 100, and 200 μmol/L of Calycosin, the absorbance values of renal cancer 769-P cell were 0.99 ± 0.06, 0.74 ± 0.07, 0.60 ± 0.03, 0.55 ± 0.05, 0.40 ± 0.06, 0.21 ± 0.04, respectively; compared with 0 μmol/L, the Calycosin could reduce the survival rate of 769-P cell ( P<0.05). The number of clones of 769-P cell in the control group and the Calycosin group was 109.80 ± 13.19 and 60.66 ± 11.22, respectively, and the number of clones of the 769-P cell in the Calycosin group was decreased, the difference was statistically significant ( t=5.67, P<0.01). The relative migration rates of 769-P cell in the control group and the Calycosin group were (43.13 ± 3.82)% and (14.27 ± 3.25)%, respectively, after the 769-P cell were treated with Calycosin, the cell migration ability was weakened ( t=5.71, P<0.05). The relative expression levels of miRNA-1246 in 769-P cell of the control group and the Calycosin group was 1.03 ± 0.12 and 6.99 ± 1.84, respectively, and the relative expression levels of CXCR4 mRNA was 7.17 ± 2.96 and 0.98 ± 0.06, respectively, showed that Calycosin can up-regulate the expression of miRNA-1246 in 769-P cell ( t=3.24, P<0.01), and down-regulate the expression of CXCR4 mRNA ( t=4.18, P<0.01). Compared with the control group, the Calycosin could down-regulate the expression of CXCR4 protein and ERK pathway protein in 769-P cell. Conclusion:Calycosin can inhibit the proliferation and migration of renal cancer 769-P cell, and its mechanism may be related to up-regulating the expression of miRNA-1246 and blocking the CXCR4/ERK pathway.

The World Health Organization (WHO) classification serves as the internationally recognized standard for diagnosing and classifying hematopoietic and lymphoid tissue tumors(WHO-HEAM). Since 2001, it has undergone multiple upgrades and revisions, updating, clarifying, and refining previous tumor diagnostic and classification standards while incorporating numerous new genetic and molecular biological subtypes. In 2022, two classification proposals emerged due to a wealth of clinical and scientific research results: the fifth edition of the WHO hematopoietic and lymphoid tissue classification (WHO-HAEM5), published in Leukemia journal; and the International Consensus Classification (ICC), published in Blood journal. These two schemes differ in their approach to classifying hematopoietic and lymphoid tissue tumors, posing challenges for clinical laboratory diagnosis and treatment.

Objective:To explore the influencing factors and implementation paths of medical and preventive integration of chronic disease in county medical communities (CMCs), providing references for further promoting the integration of medical and prevention and improving the collaborative mechanism of medical and prevention.Methods:From October to November 2023, based on the principle of geographically balanced sampling, medical staff from 6 leading hospitals and 18 other member units of 6 CMCs in Zhejiang Province were selected as survey subjects. A self-designed survey questionnaire was conducted, mainly including the development and evaluation of chronic disease medical and preventive integration services in CMCs. The service development was designed according to the collaborative symbiosis management model, including 4 dimensions of collaborative symbiosis scenarios, willingness, ability, and process, as well as 11 secondary elements. Using secondary elements as the conditional variables and the integration effect of chronic disease medical and prevention as the outcome variable, a qualitative comparative analysis method was used to explore the relationship between multiple conditional variables and their combinations with high integration effect of chronic disease medical and prevention.Results:571 valid questionnaires were collected, with an effective response rate of 96.62%. The consistency of a single secondary element(including conditional non sets) on the high effectiveness of medical and preventive integration was less than 0.9, which cannot constitute a necessary condition for explaining the outcome variable. The configuration analysis results showed that the consistency of the condition combination formed by the interaction of multiple secondary elements was 0.835-0.845, indicating that the condition combination of multiple elements constituted a sufficient non necessary condition for the high integration effect of chronic disease medical and prevention. The configuration path for achieving high integration of medical and preventive effects could be divided into four categories, among which the feature of scenario-process dominance was to create a perfect service scenario and service process as the main focus; The characteristic of the willingness-process dominant type was to stimulate the service willingness of medical staff and improve the service process as the leading factor; The characteristic of the scenario-willingness-ability dominant type was to create a comprehensive service scenario, stimulate the service willingness of medical staff, and enhance service capabilities as the main focus; The characteristic of the willingness-ability-process dominant type was to stimulate the service willingness of medical staff, enhance service capabilities, and improve the service process as the dominant factor. In addition, the four types of configuration paths mentioned above all covered the two secondary elements of endogenous dynamics and professional competence, with a total coverage of 0.626 and a total consistency of 0.821.Conclusions:The configuration path formed through the interaction of multiple elements can effectively achieve the integration of chronic disease medical and prevention. The CMCs should choose the appropriate configuration path based on the actual situation. In addition, special attention should be paid to the endogenous motivation and professional capacity building of medical staff.

Objective To prepare a dissolvable microneedle(DMN)with a tip-layer loaded with hyaluronic acid(HA)modified sinomenine hydrochloride liposomes(HA-SMH-Lip),as well as characterize,evaluate its in vitro transdermal permeability,cellular uptake ability,and anti-inflammatory ability.Methods HA-SMH-Lip-DMNs were prepared by a two-step casting method,and the drug loading capacity was determined using HPLC.The morphology,skin permeation properties and in vitro transdermal ability were investigated by scanning electron microscopy,puncture assay and Franz diffusion cell method.Fluorescent microneedles were prepared by replacing HA-SMH-Lip with fluorescein isothiocyanate liposomes(HA-FITC-Lip/FITC-Lip).The uptake behavior of inflammation cells on HA-FITC-Lip-DMNs/FITC-Lip-DMNs was investigated using a flow cytometer and a fluorescence microscope.To evaluate the anti-inflammatory activity of HA-SMH-Lip-DMNs,the levels of inflammatory factors including nitric oxide(NO),tumor necrosis factor α(TNF-α),interleukin 1β(IL-1β),and IL-10 in cell supernatants were measured using an ELISA kit.Results The prepared HA-SMH-Lip-DMNs have uniform shape and size,integral and visually pleasing array,and an average drug loading of(114.01±1.04)μg.Additionally,they have good puncture ability.The results of in vitro transdermal experiments showed that the accumulated amounts of HA-SMH-Lip-DMNs were(101.47±2.91)μg·cm-2 at 36 hours.Its transdermal ability was better than that of the SMH solution group and SMH liposome group.In vitro cellular uptake results indicated that HA-FITC-Lip-DMNs were more effectively taken up by RAW 264.7 cells(P＜0.01).Compared to the model group,HA-SMH-Lip-DMNs group significantly reduced TNF-α,IL-1β,and NO levels while increase IL-10 levels(P＜0.01).Conclusion The prepared HA-SMH-Lip-DMNs have a complete and beautiful morphology with excellent cellular uptake capability,remarkable in vitro transdermal performance,and potent anti-inflammatory properties.HA-SMH-Lip-DMNs are expected to become a new type of transdermal drug delivery system.

Objective To develop exercise programs for patients with total hip replacement at different stages in order to promote postoperative rehabilitation and functional recovery.Methods According to the"6S"evidence pyramid model,using computer,a systematic search was conducted using computer-based top-down methods across BMJ Best Practice,Up To Date,the Joanna Briggs Institute evidence-based practice database(JBI),the Centre for Evidence-Based Healthcare,the National Institute for Health and Care Excellence(NICE)website,the Guidelines International Network(GIN),the National Guideline Clearinghouse(NGC),the Scottish Intercollegiate Guidelines Network(SIGN),Medlive,Cochrane Library,Embase,PubMed,CINAHL,Web of Science,China National Knowledge Infrastructure(CNKI),China Biomedical Literature Service System,Wanfang Data Knowledge Service Platform,and VIP Database,to select literature related to exercise for patients undergoing total hip replacement.Three researchers independently assessed these documents and extracted evidence to preliminarily form exercise programs.The Delphi method was used to further validate the scientific and practical aspects of the exercise programs by two rounds of consultation.Results Specific exercise programs for patients undergoing total hip replacement were developed for the preoperative stage,postoperative 1(within 1 week after operation),postoperative stage 2(2-6 weeks after operation),and postoperative stage 3(7-12 weeks after operation),with toatal 41 items.Conclusion The exercise programs developed in this study are scientifically sound and reasonable.They can provide reference for medical staff and patients in related fields.

Objective Liver cancer is the second leading cause of tumor-related death.The efficacy of local thermal ablation is comparable to surgical resection for the early hepatocellular carcinoma(HCC),and the ablation technique is minimally invasive,repeatable,and has a low complication rate.However,early recurrence((2 years)is the main cause of death after HCC ablation,but there is still a lack of accurate and reliable prediction models for early recurrence.Therefore,this survey intended to construct prediction models for early recurrence of HCC after ablation by using preoperative gadoxetic acid disodium-enhanced magnetic resonance(MR)images data combined with radiomics methods,evaluate and verify their predictive efficacy.To explore the application value of contrast-enhanced MRI imaging before ablation in the prognosis assessment of HCC patients,and to provide reliable data and theoretical basis for clinical treatment decisions.Methods A retrospective study was performed on 120 patients with HCC who underwent ablation and all the patients were underwent contrast-enhanced MRI examination within 1 month.A total of 1318 radiomic features were extracted from each patient by using preoperative T2-weighted sequence(T2WI)images of contrast-enhanced MRI.After feature selection,six machine learning algorithms would be used for construction of models and comparison.Finally,Logistic regression analysis was used to establish a clinical model,a radiomics model and a combined model which included the above risk factors and radiologic features.The nomogram was constructed based the combined model to evaluate the differentiation,accuracy and clinical benefit.Results Five radiomic features most closely related to early recurrence were identified and selected for model construction.The radiomic model had effective predictive performance,with AUC of 0.80 in the training sets.Two clinical risk factors associated with early recurrence,including tumor number and peritumoral hypodensity on the hepatobiliary phase,were selected to established a clinical-radiological-radiomics(CRRM)model,with AUC as high as 0.92 in the validation sets.The nomogram of CRRM model was constructed and the calibration curves indicated the goodness of fit.Decision curve analysis further confirmed the clinical usefulness of CRRM model.Conclusion The radiomics model of preoperatively contrast-enhanced MRI-T2WI image features was identified be effective to predict HCC early recurrence.In contrast,the CRRM model could be used as a more comprehensive and superior tool to predict individual probability of early recurrence.Patients at high risk of early recurrence could be identified and the appropriate and effective preoperative treatments could also be taken,to improve the prognosis and long-term survival rate of HCC patients the individualized treatment strategies should be formulated.

With the demand for precise and efficient endodontic microsurgery,dynamic navigation technology has been reported for endo-dontic microsurgery in recent years,which is a digital navigation technology combining 3D reconstruction and spatial position alignment,pro-viding a new treatment model for minimally invasive endodontic microsurgery.In this paper,a case of endodontic microsurgery assisted by re-al-time dynamic navigation is reported.

The stenosis and embolization of internal fistula vessels directly affect the clinical treatment effect of maintenance hemodialysis patients, and the study of the mechanism of internal fistula stenosis has become a research hotspot in recent years. Previous studies mainly focused on the hemodynamics and pathophysiology of blood vessel wall, and there were few studies on molecular biology and its related signaling pathways. This paper reviews the hemodynamics of the vascular pathway of internal arteriovenous fistula (AVF), the pathophysiological mechanism, molecular biology, and changes in various signaling pathways of AVF dysfunction at home and abroad, in order to provide references for the study of AVF dysfunction.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.